Refereed journal article or data article (A1)

Sex differences in left ventricular remodelling in patients with severe aortic valve stenosis




List of AuthorsKuneman Jurrien H, Singh Gurpreet K, Milhorini Pio Stephan, Hirasawa Kensuke, Hautemann David, van der Kley Frank, Ajmone Marsan Nina, Knuuti Juhani, Delgado Victoria, Bax Jeroen J

PublisherOxford Academic

Publication year2022

JournalEHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging

Journal name in sourceEuropean heart journal. Cardiovascular Imaging

Journal acronymEur Heart J Cardiovasc Imaging

Article number jeab174

Volume number23

Issue number6

Start page781

End page789

ISSN2047-2404

eISSN2047-2412

DOIhttp://dx.doi.org/10.1093/ehjci/jeab174


Abstract

Aims : Women with severe aortic stenosis (AS) have better long-term outcome after transcatheter aortic valve implantation (TAVI) but worse survival after surgical aortic valve replacement compared with men. Whether this is related to sex differences in left ventricular (LV) remodelling is unknown. The aim of this study was to examine the sex differences in LV remodelling with multidetector row computed tomography (MDCT) and outcome in patients with severe AS undergoing TAVI between 2007 and 2018.

Methods and results : A total of 289 patients (age 80 ± 6 years, 54% male) were included. LV volumes, mass, and function were analysed on pre-procedural MDCT scans. Women showed smaller LV volumes and mass compared with men. Patients were classified into four LV remodelling patterns: concentric hypertrophy (50%) was the most frequent pattern of LV remodelling followed by eccentric hypertrophy (33%), normal geometry (13%), and concentric remodelling (4%). Men showed more concentric remodelling compared with women (91% vs. 9%, respectively, P = 0.011). However, no differences were observed in the remaining LV remodelling patterns. During a median follow-up of 3.8 (IQR 2.2-5.1) years after TAVI, 87 (30%) patients died. Women demonstrated better outcome after TAVI compared with men (log-rank χ2 = 4.29, P = 0.038). No association was observed between the interaction of the LV remodelling patterns and sex with outcome.

Conclusion : LV concentric hypertrophy and eccentric hypertrophy are similarly observed in men and women with severe AS but concentric remodelling was more common in men. Women demonstrated better outcome after TAVI when compared with men. The interaction between the LV remodelling patterns and sex was not associated with survival.

d with men. The interaction between the LV remodelling patterns and sex was not associated with survival.


Last updated on 2023-27-11 at 11:43